Comparative Study between Bonfils Intubation Fiberscopy, Fiberoptic Bronchoscopy and Direct Laryngoscopy in Difficult Airway Patients

Document Type : Original Article

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Abstract

Background: Airway management has progressed since the first orotracheal intubation using a blind digital technique. The Macintosh laryngoscope has allowed tracheal intubation under direct vision.
Objective: The present study was designed to compare the effect of fiberoptic intubation, bonfils intubation and direct laryngoscope on the hemodynamics, time taken for intubation, stress response hormones (glucose, cortisol and C-peptide) in difficult airway patients.
Subjects and Methods: This Prospective, randomized, controlled study included a total of 90 adult patients aged 21-50 years with physical status (ASA) I or II of both sexes undergoing general anesthesia for elective surgical procedures. Patients were subjected to clinical examination and full investigations and assessment of the patients’ airway by El-Ganzori score. Patients were randomly allocated into three equal groups, 30 patients each: Group A: direct laryngoscope, Group B: fiberoptic bronchoscope and Group C: bonfils fiberoscope.
Results: Fiberoptic has significant hemodynamic stability after one min of intubation than bonfils and direct laryngoscope. While bonfils has significant hemodynamic stability after five minute and ten minutes after intubation and had highly significant short time of intubation than fiberoptic and direct laryngoscope. As regard to number of attempts, most patients were successfully intubated on the first attempt in group B, while on the second attempt in groups A, and group C which was statistically non-significant between three groups.
Conclusions: It could be concluded that bonfils has hemodynamic stability after five minute and ten minutes after intubation and also had the shortest time of intubation than fiberoptic and direct laryngoscope.

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